尿外泌体miR-29c对器官和非器官局限性膀胱尿路上皮癌临床结局的预测价值  

Predictive value of urinary exosomal miR-29c in clinical outcomes of organ-and non-organ-confined bladder urothelial carcinoma

作　　者：王志刚[1] 董青川[1] 孙羿[1] 段万里[1] 管振锋 潘亮 WANG Zhigang;DONG Qingchuan;SUN Yi;DUAN Wanli;GUAN Zhenfeng;PAN Liang(Department of Urology,Shaanxi Provincial People’s Hospital,Shaanxi,Xi’an 710068,China)

机构地区：[1]陕西省人民医院泌尿外科,西安710068

出　　处：《临床外科杂志》2024年第2期148-152,共5页Journal of Clinical Surgery

基　　金：陕西省重点研发计划项目(2017SF-193);陕西省自然科学基础研究计划项目(2023-JC-YB-769)。

摘　　要：目的 探讨尿外泌体微小RNA(miR)-29c对器官和非器官局限性膀胱尿路上皮癌(BUC)临床结局的预测价值。方法 2017年1月~2022年3月,从我院泌尿外科选取152例BUC病人作为验证集。另外,从我院体检中心选择了126例非癌对照。采用实时荧光定量PCR法检测尿外泌体miR-29c表达水平。结果 验证集BUC病人尿外泌体miR-29c水平低于非癌对照组,差异有统计学意义(P<0.05),而尿外泌体miR-17-5p水平和miR-590-5p水平比较无明显差异(P>0.05)。尿外泌体miR-29c水平诊断BUC的ROC曲线下面积为0.969(95%CI:0.953~0.986),相应的敏感性和特异性分别为92.1%和90.2%。亚型分析中,非器官局限性BUC病人尿外泌体miR-29c水平较器官局限性BUC病人进一步降低(P=0.009)。预后分析中,尿外泌体miR-29c高表达组病人总生存期、无病生存期和疾病特异性生存期均更长(P<0.05)。结论 尿外泌体miR-29c低水平是BUC病人不利的预后因子,有希望作为器官和非器官局限性BUC不良临床结局的预测标志物。Objective To investigate the predictive value of urinary exosomal microRNA(miR)-29c in the clinical outcome of organ-and non-organ-confined bladder urothelial carcinoma(BUC).Methods From January 2017 to March 2022,152 patients with BUC were recruited from the Department of Urology in our hospital as a validation set.In addition,126 non-cancer controls were selected from the physical examination center of our hospital.The expression level of urinary exosomal miR-29c was detected by real-time quantitative PCR.Results In the validation set,urinary exosomal miR-29c level in BUC patients was significantly lower than that in non-cancer control group(P<0.05),while urinary exosomal miR-17-5p level and miR-590-5p level were not significantly different(P>0.05).The area under ROC curve of urinary exosomal miR-29c for the diagnosis of BUC was 0.969(95%CI:0.953~0.986),and the corresponding sensitivity and specificity were 92.1%and 90.2%,respectively.In subtype analysis,urinary exosomal miR-29c levels were further reduced in patients with non-organ-confined BUC compared with patients with organ-confined BUC(P=0.009).Overall survival(OS),disease-free survival(DFS)and disease-specific survival(DSS)were longer in the urinary exosomal miR-29c high expression group(P<0.05).Conclusion Low levels of urinary exosomal miR-29c are an adverse prognostic factor for survival in patients with BUC,and are promising as a predictor of adverse clinical outcomes of organ-and non-organ-confined BUC.

关 键 词：尿外泌体miR-29c 器官和非器官局限性膀胱尿路上皮癌 临床结局 

分 类 号：R737.14[医药卫生—肿瘤]